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Monday, April 2, 2012

Sex, obesity and the seven deadly sins

In 2003, The Economist carried a major article on obesity and featured
the topic on its front cover, which has become a PowerPoint icon in obesity
lectures.The images imply that
throughout time, our ancestors were lean and fit and that obesity is a modern
phenomenon, arising from today’s food industry, as witnessed by the use of a
McDonalds package in the illustration of modern obese man. ‘Not so’, says
Louise Foxcroft in her recent book “Calories and Corsets” which documents the
history of obesity and dieting and which forms the basis of this blog.

The Venus of Berekhat
from the Golan Heights is believed to date from 500,000 BC, prior to Homo
Sapiens and in the Era of Homo Erectus. Like later figures such as the Hohle
Fels Venus from 35,000 BC, females are portrayed as being grossly obese with
pendulous breasts and multiple folds of fat. It is of course impossible to say
whether these were based on real cases or are merely symbolic of the recognised
need of a minimal amount of body fat for female fertility, grossly exaggerated
in these cases (see blog of February 20th 2012).However, the very fact that folds of fat are depicted
implies some existing cases on which to draw inspiration. Hippocrates, Socrates
and most notably, Galen, the father of medicine for a millennium, all espoused
diet and physical activity as central to health and in all of their writings
they titrate their advice on caloric restrictions to the need for physical
activity. Vomiting was also raised
to an art form by the Greeks.

The interest in food and obesity of the early Greeks continued on
through the era of the Roman Empire and the advent of printing was to reveal
just how passionate the world was with diet and obesity. Luigi Cornado
(1464-1566) published his book “The art of living long” in 1558 (he was
then 94 years old!) in many editions and in many languages. Louise Foxcroft
quotes Milton from Paradise Lost: “If thou well observe the rule of ‘Not Too
Much’ by temperance taught in thou eat’st what drink’st, seeking from thence due
nourishment, not gluttonous delight, till many years over thy head returns”.
One could return to the issue that these were concerns for jus a few and that
obesity was about as common as murder. However, the writings of the day say
otherwise. Cornado wrote that gluttony “kills every year...as great a number as
would perish during the time of a most dreadful pestilence, or by the sword or
fire of many bloody wars”. This was echoed by the English parliamentarian John
Hales who, in the 16 century believed that obesity claimed more lives than the
sword or plague. Only after the industrial revolution did we start to collect
the relevant statistics on diet and health and by 1908, enough data had been
gathered by the New York Life Insurance company to declare that obesity in
those aged 35 years or more was seriously disadvantageous from a mortality
point of view. The more widespread morbidities of obesity, diabetes and
hypertension, would not have been counted at that time. For actuarialists in
1908 to reach this conclusion meant that there were data stretching back some
time into the 19th century on height and weight and that obesity was a public
health issue over two centuries ago. Independent data from the US military bear
this out. Not only has the human race lived with obesity since time immemorial,
but we have also lived with the stigmatization of the obese. As Louise Foxcroft
writes:” The insults that are often used against fat people........also have
ancient roots. The old disease of polysarcia, the pathological condition of too
much flesh was thought to indicate a lazy, phlegmatic, stupid person who just
could not control themselves”.

This brings us to the moral stance of society on obesity. There are
seven deadly sins in certain Christian faiths of which two might be regarded as
“cerebral” (Pride and Envy) with five involving what we call today “lifestyle
choices”: Gluttony and Greed associated with diet, Sloth associated with a sedentary
lifestyle and of course Lust associated with sex. Food was the perfect
illustration of the need to balance pleasure and sin and so great was the
former and so dire the latter in its consequences that the concept of ascetism
evolved with hermits living lives of great self sacrifice effectively, taking
total control of their body in terms of food, exercise and sex, so that their
body (effectively detached from “them”) could not get on the way of the pursuit
of the moral ideal.Gluttony was
by far the most visible of the seven deadly sins and it was gluttony that attracted
most attention from those seeking the afterlife. As ever, the organised
churches had very profound views on gluttony, none more so than Pope Gregory
the Great who managed to define 6 levels of gluttony: “nimis (eating too
much), ardenter (eating with unbecoming eagerness), forente
(eating wildly), praepropere (not waiting until decent mealtimes), laute
(enjoying food that is too expensive) and studiose (being too picky)”.

Now it could be argued that this is all very interesting but that it
has nothing to do with the modern epidemic of obesity. “Not so” say I. The high
priests of obesity apparently know the cause of this putatively modern
epidemic. It is a food chain that is low cost, engineered to pamper our
hedonism and convenient to suit our sedentary lifestyle. Once we know the
problem, we can now organise the solution, which means policing, taxing,
labeling, restricting, banning and whatever. Louise Foxcroft in her book quotes
the anthropologist Meyer Fortes: ”It is not so much that food is good but that
it is good to forbid”. If just for
a moment, the hierarchy of obesity were to look at this issue historically,
then they would see the present issue as one of scale rather than uniqueness. Just as we have always had sexually
transmitted disease, we have simply far more of it today than ever before. By
recognising that obesity has always been with us and at a scale of measurable
concern for at least two centuries, we would immediately have to accept that
simple solutions drawn from societal experience in the last half century will just
distort a true vision of the solution. Obesity will be around for centuries to
come. Either we tackle this long term from the food chain to the built
environment or we just fool ourselves. Careers are built on the latter. Dreams
are built on the former.

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"Ever seen a fat fox ~ Human obesity explored"

About Me

I graduated from University College Dublin in 1971 with an Masters in Agricultural Chemistry, took a PhD at Sydney University in 1976 and joined the University of Southampton Medical School as a lecturer in human nutrition in 1977. In 1984 I returned to Ireland to take up a post at the Department of Clinical Medicine Trinity College Dublin and was appointed as professor of human nutrition. In 2006 I left Trinity and moved to University College Dublin as Director of the UCD Institute of Food and Health. I am a former President of the Nutrition Society and I've served on several EU and UN committees on nutrition and Health. I have published over 350+ peer reviewed scientific papers in Public Health Nutrition and Molecular Nutrition and am principal investigator on several national and EU projects (www.ucd.ie/jingo; www.food4me.org). My popular books are "Something to chew on ~ challenging controversies in human nutrition" and "Ever seen a fat fox: human obesity explored"